High return to sports and return to work rates after anatomic lateral ankle ligament reconstruction with tendon autograft for isolated chronic lateral ankle instability

Rupp, Marco-Christopher; Degenhardt, Hannes; Winkler, Philipp W.; Hinz, Maximilian; Ehmann, Yannick J.; Imhoff, Andreas B.; Pogorzelski, Jonas; Themessl, Alexander

doi:10.1007/s00167-022-06937-0

Cited by 11 publications

(4 citation statements)

References 49 publications

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“…This has many disadvantages, such as a large surgical incision, influence on the function of other tendons, change of the normal structure of the lateral malleolus, and ankle joint ROM restriction. After ligament reconstruction with an autologous tendon[ 75 ], work and sports can be quickly resumed. However, due to the change in the normal anatomical structure of the ankle ligament, postoperative complications, such as ankle joint activity restriction and strain pattern change, are often observed[ 76 ].…”

Section: Management Measuresmentioning

confidence: 99%

Progress in diagnosis and treatment of acute injury to the anterior talofibular ligament

Chen¹,

Wang²,

Li³

et al. 2023

World J Clin Cases

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Injury to the anterior talofibular ligament (ATFL) is a common acute injury of the lateral foot ligament. Untimely and improper treatment significantly affects the quality of life and rehabilitation progress of patients. The purpose of this paper is to review the anatomy and the current methods of diagnosis and treatment of acute injury to the ATFL. The clinical manifestations of acute injury to the ATFL include pain, swelling, and dysfunction. At present, non-surgical treatment is the first choice for acute injury of the ATFL. The standard treatment strategy involves the “peace and love” principle. After initial treatment in the acute phase, personalized rehabilitation training programs can be followed. These may involve proprioception training, muscle training, and functional exercise to restore limb coordination and muscle strength. Static stretching and other techniques to loosen joints, acupuncture, moxibustion massage, and other traditional medical treatments can relieve pain, restore range of motion, and prevent joint stiffness. If the non-surgical treatment is not ideal or fails, surgical treatment is feasible. Currently, arthroscopic anatomical repair or anatomical reconstruction surgery is commonly used in clinical practice. Although open Broström surgery provides good results, the modified arthroscopic Broström surgery has many advantages, such as less trauma, rapid pain relief, rapid postoperative recovery, and fewer complications, and is more popular with patients. In general, when treating acute injury to the ATFL, treatment management and methods should be timely and reasonably arranged according to the specific injury scenario and attention should be paid to the timely combination of multiple therapies to achieve the best treatment results.

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Section: Management Measuresmentioning

confidence: 99%

Progress in diagnosis and treatment of acute injury to the anterior talofibular ligament

Chen¹,

Wang²,

Li³

et al. 2023

World J Clin Cases

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show abstract

“…In clinical practice, conservative treatment is initially recommended for CLAI, with surgery being considered if symptoms do not improve or worsen after 3-6 months of conservative treatment. The surgical techniques include anatomical repair [8][9] , anatomical reconstruction [10][11] , and non-anatomical reconstruction [12][13] . Anatomic repair of the ATFL offers advantages such as minimal surgical trauma, simplicity in operation, and favorable postoperative recovery; thus it is currently regarded as the preferred choice for repairing the ligament.…”

Section: Introductionmentioning

confidence: 99%

The precision of technical aspects in the minimally invasive Broström-Gould procedure：A Cadaveric Anatomical Study

Zhang,

Li,

Yao

et al. 2024

Preprint

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Background A comprehensive understanding of the anatomy of the anterolateral ankle joint and its interrelationships is essential for advancing the development of minimally invasive Brostrom-Gould procedure, thereby enhancing surgical efficacy and minimizing postoperative complications. Methods Ten fresh human ankle specimens were dissected to observe the shape and trajectory of the lateral bundle of the inferior extensor retinaculum（IER） and its relationship with the deep fascia. To observe the relationship between the ankle capsule and the anterior talofibular ligament（ATFL）. The center of the insertion point of ATFL at the lateral malleolus was used as the reference point.The vertical distance from the reference point to the fibula tip, the horizontal distance from the reference point to the lateral branch of the superficial peroneal nerve, the shortest distance from the reference point to IER，and the narrowest width of the IER were measured. The tension of ATFL was observed and measured. To describe the minimally invasive Broström-Gould procedure according to the anatomical characteristics of the anterolateral ankle joint. Results Among the 10 cases, 8 cases (80%) had double bundles of ATFL, 2 cases (20%) had single bundle of ATFL, and no outer superior oblique bundle was observed in IER. The vertical distance from the reference point to the fibula tip was 1.2±0.3(range 1.1-1.3)mm. The shortest distance from the reference point to the level of the superficial peroneal branch was 28.2±4.3(range 24.5-32.4)mm. The shortestdistance from the reference point to IER was 12.5±0.6(range 12.1-12.9)mm, and the width of IER at this point was 7.2±0.3(range 7.0-7.6)mm. The Angle between this point and the ATFL insertion and the fibula longitudinal axis was about 60°±2.8°(range 58.1°-62.1°)mm. The space between the anterolateral deep fascia of the ankle joint and the ankle capsule is very small, and only a few fat granules are separated between them. The ATFL is largely fused to the ankle capsule. Conclusions The results showed that in the minimally invasive Broström-Gould technique for lateral ankle stabilization, the Broström procedure actually sutured the insertion of the ATFL together with the ankle capsule to the anterior edge of the lateral malleolus. In the Gould procedure, the deep fascia was mostly reinforced with the ankle capsule. The maximum tension was obtained when the Gould suture needle direction was at an Angle of 60° to the longitudinal axis of the fibula.

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“…Several surgical treatment options have been described to restore ankle stability [ 31 , 40 ]. Repair of ankle ligaments with a modified Broström–Gould procedure, consisting of lateral ligament imbrication with direct suture repair and transfer of the extensor retinaculum, remains the current gold standard for surgical management of CLAI [ 29 , 40 ]. However, it has been reported that 25% of patients are unable to return to sport [ 7 , 12 , 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Ankle ligament reconstruction‐return to sport after injury scale and return to sports after ankle ligament reconstruction or repair—A systematic review

Wang,

Hinz,

Buchalter

et al. 2024

J. exp. orthop.

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PurposeTo systematically review existing literature regarding the ankle ligament reconstruction‐return to sport after injury (ALR‐RSI) scale and to assess its correlation with Return to sport and functional outcomes as well as feasibility, reliability and consistency.MethodsA systematic review of the literature based on the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) was conducted using PubMed, Embase and Cochrane Library. Studies that evaluated psychological readiness to return to sport after ankle ligament reconstruction or repair for the treatment of chronic lateral ankle instability using the ALR‐RSI scale were included. The results from each study were pooled, and weighted means and overall rates were calculated.ResultsIn total, 157 patients (53.2% male, mean age: 34.2 years) from three articles were included. Overall, 85.0% of patients reported successful return to sport, but only 48.9% of patients returned to the preoperative sporting level. All studies reported a significant difference in psychological scores between patients who returned to sport and those who did not. Pooled mean patient‐reported outcome measures, reported as the American Orthopaedic Foot and Ankle Society Ankle‐Hindfoot (AOFAS, three studies) Score and Karlsson‐Peterson Score (three studies), were 82.7 (range: 29–100) and 81.7 (range: 25–100), respectively. The ALR‐RSI scale demonstrated strong correlations with the AOFAS Score and Karlsson‐Peterson Score.ConclusionPatients who returned to sport after ankle ligament reconstruction or repair exhibited higher psychological readiness compared to those who did not. The ALR‐RSI scale showed strong correlations with ankle function. Evaluation of psychological readiness using the ALR‐RSI scale may provide an additional tool in the assessment of patients who underwent ankle ligament reconstruction or repair.Level of EvidenceLevel III, systematic review.

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High return to sports and return to work rates after anatomic lateral ankle ligament reconstruction with tendon autograft for isolated chronic lateral ankle instability

Cited by 11 publications

References 49 publications

Progress in diagnosis and treatment of acute injury to the anterior talofibular ligament

Progress in diagnosis and treatment of acute injury to the anterior talofibular ligament

The precision of technical aspects in the minimally invasive Broström-Gould procedure：A Cadaveric Anatomical Study

Ankle ligament reconstruction‐return to sport after injury scale and return to sports after ankle ligament reconstruction or repair—A systematic review

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